Lyme and Prefrontal Cortex Problems

The Prefrontal Cortex

In order to explain this important part of your brain that sits directly in back of your forehead I need to tell you about the Disney movie UP, Adolph Hitler, a Roman General, and my dog Lady. For those of you who have not seen Pixar’s UP, you now have some homework because the humorous observation of the dogs in this animated blockbuster give real insight into the prefrontal cortex.

In the story, balloon salesman Carl Fredricksen and his energetic wife Ellie live a wonderful life with dreams of adventure that always seems beyond financial reach. After Ellie’s death, Carl grows quiet and confined until meeting 8-year-old Wilderness Explorer Russell who is eager to get his “helping the elderly” pin. Without retelling the entire story, this unlikely duo travel to a faraway land and meet the antagonist as well as new friends like Dug, a dog with a special collar that allows him to speak, and Kevin, a rare 13-foot tall flightless bird (but a very nice bird, as all Kevin’s are).

Before you start thinking that I have ulterior motives for having children, there is a great lesson in the story’s antagonist’s (famed explorer/inventor Charles Muntz) dogs. Fitted with their talking collars, the dogs pursue the pair to capture their new friend, the exotic bird Kevin. In doing so we see the truth about dogs – they have a very small prefrontal cortex, as I’m sure you were thinking as well when you watched the movie.

“Squirrel”

Once, when capture seemed inevitable and the adventure doomed to failure as the talking dogs were at the verge of victory, Russell ingeniously distracted the animals from their goal by shouting, “Squirrel!” The prefrontal cortex is necessary to stay on task, remain focused on intention and block out distractive issues. Humans should have no problem with focus, dogs do. No matter how obedient to their evil master the dogs desired to be, dog are dogs and dogs chase squirrels.

The prefrontal cortex allows attention on intention; it is the schoolmaster keeping the students on task and without it there would be chaos directly proportional to the lesion. It is primarily responsible for regulating behavior, mediating conflicting thoughts, making choices between right and wrong, and predicting the probable outcomes of actions or events. It governs social control, such as suppressing emotional or sexual urges. Since the prefrontal cortex is the brain center responsible for receiving data from the world and deciding on actions, it is most strongly implicated in human qualities like consciousness, general intelligence, and personality. It is what makes us unique as humans – the size of our prefrontal cortex.

1941

It was the summer of 1941, the plan was simple, but Hitler was alone in his thinking that it would be simple to perform. Given the size of Russia, the German army would be divided into 3 groups. Army Group North would advance through the Baltic States towards Leningrad, Army Group South would move into the Ukraine and then the Caucasus to take the wheat and oil fields of Russia, and Army Group Center would advance through White Russia towards Moscow.

Germany had already conquered most of Europe and the Fuhrer’s success following his planned Blitzkrieg was unprecedented. He thought Germany was unbeatable and he trusted his track record over wise counsel. This obstinacy became the cause of many heated debates between Hitler and his Generals and proved disastrous for “Operation Barbarossa,” the attack on Russia. When a country goes to war, it is only sensible that the Government and the Military have already determined the enemy’s “Center of Gravity”, and have already planned on how to neutralize it. The enemy’s “Center of Gravity” can be their armed forces, their capital, a powerful ally, etc.

Hitler and his Generals disagreed from the start about what Russia’s “Center of Gravity” was. The Generals thought it was Moscow, while Hitler thought it was Ukraine and the Oil fields of the Caucasus. Hitler’s reasoning, if it can be called that, was based on history. Napoleon had taken Moscow, but the Russians had not given in, and in the end Napoleon had to retreat, with disastrous results for his Empire. Hitler was determined not to repeat that mistake; he was going to head south, take the Ukraine and the Oil fields, and deny the Russians the resources he felt they needed to continue the war.

His Generals could not have disagreed more. They argued that Russia was so vast, and capable of replacing whole armies, that only the capture of Moscow would destroy the Soviet Regime. They argued that Moscow was the political and logistical hub of European Russia, and if it was taken, the Russians would not be able to continue the war west of the Urals. A simple glance at any world atlas will indeed show that in Western Russia, “all roads lead to Moscow.”

The General’s reasoning was that since most of Russia’s population, resources and industry were located west of the Urals, even if the Russians elected to fight on, it would be a lost cause. Finally, they argued that Stalin was so feared and despised, (nearly a million citizens took up arms against Russia’s military) that if the Red Army was destroyed, and Moscow taken, the people would overthrow him and welcome Germany’s rule.

Hitler was a ruthless dictator, and therefore had the last word; in this case he was absolutely wrong. The attempt to seize of Ukraine in 1941 was blind optimism, born out of pride in the heart of a deranged tyrant. Even if the Germans had taken Ukraine and all of the oilfields, the Soviet Regime would still be intact and worse, given the still considerable Russian armies to the north and the long lines of communications the Germans would have in the south, the Russians could have possibly cut off the German army in southern Russia as they actually did in late 1942.

Decision Making

What does this have to do with the prefrontal cortex? Recent research on why we do what we do has concentrated on decision making. There appears to be a dichotomy in cognitive neuroscience between reflective versus reflexive decision making. Reflective, goal-oriented, or what has been termed model-based thinking is now been shown to be a right prefrontal function. This means if I have greater left-brain dominance, I will be more prone to habitual, less reasoned, or what is known as model-free decisions.

Right-brain dominant people base decisions more on perspective thought, weighing consequences, and seeing possible outcomes. Left-brain dominant individuals make choices more on what was done in the past, patterns that are common, and “the way I’ve always done it.” It goes without saying that evil dictators have brain problems but I think most have two severe (very severe) lesions: right dorsolateral and right anterior cingulate damage.

A study published in Neuron in October, 2013 showed that disrupting the right dorsolateral prefrontal cortex impaired flexible model-based choices, driving behavior toward simpler, model-free (habitual) control. Blind pride may have more of a neurobiological cause than previously believed. Damage to prefrontal brain structures has been documented in psychopathic criminals as well.

These studies show that human choice behavior often reflects a competition between inflexible computationally efficient control (from the left brain) and a slower more flexible system based on weighing factors and consequences (the right brain) on the other. One can see that BOTH are necessary for optimal performance in a complex world. A commander of armed forces, a CEO of a major company and a parent of small children need healthy functioning frontal lobes to both make quick decisions based on past experience and slower, more carefully thought out choices based upon reason.

There are times we all need reflexive, non-emotional decision-making that will be efficient and give us a good chance that the outcome will be similar to past outcomes based on similar circumstances and there are other times where being able to imagine all sides of either ruling will guide us to the best selection. Imbalance is not healthy.

Would World War II have had a different outcome had Hitler had a more balanced brain? Well, yes, it wouldn’t ever have started had Hitler had a healthy prefrontal cortex. We could write an entire book on his traumatic childhood, his mother’s death of cancer, and his brain problems and conditioning but it suffices to say that one could explain all ill-behavior, no matter if demonic or innocent as having at least part of its origin in the prefrontal cortex.

Here’s something really cool for you nerds out there. Recent research on why we do what we do has concentrated on decision making. There appears to be a dichotomy in cognitive neuroscience between reflective versus reflexive decision making. Reflective, goal-oriented, or what has been termed ‘model-based’ thinking has now been shown to be predominantly a right prefrontal function (versus the left prefrontal). This means that if I have greater left-brain dominance, I will be more prone to habitual, less reasoned, or what is known as ‘model-free’ decisions.

Right-brain dominant people base decisions more on perspective thought, weighing consequences, and seeing possible outcomes. Left-brain dominant individuals make choices more on what was done in the past, patterns that are common, and “the way I’ve always done it.”

This and other studies show that human choice behavior often reflects a competition between inflexible, computationally, efficient control (from the left brain) and a slower more flexible system based on weighing factors and consequences (the right brain). One can see that BOTH are necessary for optimal performance in a complex world.

There are times we need reflexive, non-emotional decision-making that will be efficient and give us a good chance that the result will be similar to past outcomes based on similar circumstances and there are other times where being able to imagine all side of either ruling will guide us to the best selection. Imbalance is not healthy.

Conners Clinic is located on 8519 Eagle Point Blvd #170, Lake Elmo. From Minneapolis−Saint Paul International Airport (MSP) head southwest and continue onto Green Ln. Then keep right and slight right onto Glumack Dr. Next, keep right to stay on Glumack Dr and keep right at the fork and merge onto MN-5 W. After that merge onto MN-5 W and take the exit onto I-494 E. Take exit 58B to merge onto I-94 E toward Madison and take exit 250 for Radio Dr/Inwood Ave toward Washington County 13. Then use the left 2 lanes to turn left onto Inwood Ave N/Radio Dr. Finally, turn right onto Eagle Point Blvd, turn left at Eagle Point Cir and Conners Clinic will be on your right.

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“Cancer is a scary thing. I’m here to remove the confusion and give you guidance. Cancer patients are rarely told that adding natural, alternative therapies to their care can greatly mitigate their adverse reactions, improve the quality of their life, and give them their life back!” –Dr Kevin Conners

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